The Harper government has announced a new funding arrangement for Medicare, which after 2016 will be tied to economic growth in the nominal GDP. According to one estimate, this will translate into $21 billion in cuts to health-care funding over 10 years. By unilaterally imposing health-care funding cuts on the provinces, the Harper government is putting its own brand on a familiar prescription for privatization: scapegoat Medicare, ignore private health costs, pretend you don't have any money, and then cut public health care to encourage privatization.
1. Scapegoat Medicare
Immigration Minister Jason Kenney, fresh off his attack on Muslim women, was the first Tory to open the campaign against Medicare -- scapegoating it for cuts to social services. Suddenly a public education advocate, he claimed that public health-care costs are soaring and devouring provincial budgets. Kenney stated that, "For some of the provinces, if they continue in that trajectory, there will be nothing left for education, for universities, for anything else."
This is a common myth, repeated by the corporate media, that manipulates statistics created by decades of Tory and Liberal cuts at both federal and provincial levels. The relative rise in provincial health-care budgets is a statistical effect from greater cutbacks elsewhere. According to the 2011 report, "Neat, plausible and wrong: the myth of health care unsustainability" by Canadian Doctors for Medicare (CDM):
"The change in share of provincial budgets is not primarily due to increased health care spending. It is the result of decreases in other provincial spending to accommodate political decisions to cut taxes … Deep cuts in federal transfers to the provinces in the mid-1990s were compounded by provincial tax cutting policies in the latter part of the decade, causing significant reductions in total provincial budgets. Provincial revenues have fallen almost $30 billion since 1997, causing decreases in other government program spending through cuts to education, social services, and municipalities … It is tax cuts that have 'crowded out' these priorities, not Medicare."
2. Ignore private inefficiencies
Overall health costs have increased, but it's crucial to differentiate between public and private. While Medicare costs have been constant and sustainable over 30 years, overall health costs have increased -- from those sources not covered by Medicare. As the CDM report explains: "The real cost driver is precisely the thing that critics of Medicare tout as the solution: private health care. Currently 30% of all health spending is in the private sector, up from 24% in 1975 … the overall cost of care has been driven most significantly by the rising cost of pharmaceuticals."
If we want to control rising health care costs, we need to control the profit-driven private sector, federally and provincially. It's estimated that developing a universal public pharmacare program could save $10 billion annually. But federal governments have refused to make this "efficiency." Meanwhile a year ago the B.C. government slashed funding for the Therapeutics Initiative -- an independent evidence-based review board that helped promote safe and affordable pharmaceuticals.
3. Pretend there's no money
While ignoring the heightened costs of private medicine, the Tories are using the economic crisis to justify cutting public health care, claiming there's no money to cover it. According to Finance Minister Jim Flaherty, "We all realize that public finances relate to revenues and we can't pretend that we can spend money that we don't have." This ignores massive tax cuts, bank bailouts and military spending sprees. While the new health plan could cut $21 billion from health, the Tories gave a $69 billion bank bailout, are wasting $220 billion on tax cuts, and have been going on a military spending spree -- from $30 billion fighter jets, to $25 billion warships -- as part of a $490 billion military plan.
4. Cut the public to promote the private
But the Tories don't want to debate the spending priorities of the 1 per cent, so they've chosen to unilaterally impose cuts to the provinces, to encourage privatization. According to Health Minister Leona Aglukkaq, "This investment also provides the opportunity to put the divisive issues funding behind us to allow us all to focus on the real issue -- how to improve the system so you can ensure timely access to health care when needed." In other words, the government is trying to bury the question of federal funding -- which initially comprised 50 per cent of Medicare's funding -- in order to starve the provinces and encourage "timely access" through privatization, a strategy many provincial governments are happy to oblige.
This passive-aggressive approach is similar to Harper's campaign against abortion: claim to "not open the debate" while imposing cuts anyways. But this is based on a position of weakness: an overwhelming majority of people support public health care, the legacy of a grassroots movement that won Medicare and continues to defend it. Public health care is not a divisive issue: it unites us, as do other issues.
The funding is there, not only for public health care but for all the social determinants of health: income and social equality, housing and food security, education and a clean environment. But to occupy health and health care, we need to move beyond the 1 per cent world of tax cuts, bank bailouts, military spending and profit-driven medicine.